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Behavioral Health Nutrition: Nutrition & Addiction

Behavioral Health Nutrition: Nutrition & Addiction. Presented by: Presented by Josephine C. Kannike-Martins, PhD., RD., RASi Medi-Cure Health Services, Inc. P. O. Box 8360, Los Angeles, CA 90008

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Behavioral Health Nutrition: Nutrition & Addiction

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  1. Behavioral Health Nutrition:Nutrition & Addiction Presented by: Presented by Josephine C. Kannike-Martins, PhD., RD., RASi Medi-Cure Health Services, Inc. P. O. Box 8360, Los Angeles, CA 90008 P: [323-295-1136; F: [323] 295-1071

  2. Objective • Examine the Implication of addiction on nutritional well being • Strategies for intervention • Create awareness • Become an advocate • Understand it’s prevalence within our population Terminology: Substance Use Disorders (SUDs) aka (Substance Abuse)/addiction

  3. Significance of SUDs/ Addiction • 20% of total hospital costs in the U.S. are due to medical care caused by SUDs • Up to 40% of all Americans in hospital beds are treated for complications of alcohol abuse & alcoholism • One in every five Medicaid dollars spent on hospital care and one in five hospital days- attributed to SUDs

  4. Significance of SUDs cont. • Individuals who abuse alcohol, tobacco & other drugs are hospitalized twice as long as other individuals • 75% of chronic pancreatitis is caused by alcohol abuse • 65% of the strokes among young Americans are related to cigarette, cocaine or amphetamine use

  5. Significance of SUDs cont. • Youth under fifteen years of age are hospitalized longer for illness if they abuse psychoactive substances • SUDs (all inclusive) psychoactive drugs/ OTC/Rx • Nutrition & Addictions A Guide for Professionals: Ann S. Hatcher, EdD, RD (ret) CACIII, NCACII,2008

  6. Nutritional effects of SUDs Direct effects • Depletion of nutrient stores • Malabsorption of nutrients • Disrupts utilization of nutrients Indirect effects • Irritation of the mucous lining of the stomach • Diuresis, Constipation, decreases sensitivity of taste, altered perception of odors, decrease sense of feeling, decreases motivation & alterations of visual perception

  7. Physical signs • Malnutrition may be visible. • Weight loss – may be the intended reason for using. • Dry skin and hair. • May be concealed by weight gain & the appearance of health • Prevalence of fractures common among alcoholics • Impaired nutritional status Emilio Gonzalez-Reimers et al., Vitamin R & Nutritional Status are Related to Bone Fractures in Alcoholics; Alcohol & Alcoholism, Vol. 46, N2., pp148-155, 201.

  8. Characteristics of SUDs Addiction Preoccupation with acquiring and using drugs Compulsion to use despite negative consequences High relapse rate regardless of negative consequences.

  9. Implication on Health & Wellness Addiction is a chronic disorder lasting over time Effects on the body depends on substance of choice Major physical impact is on the hepatic system Regular use enables reward from the drug and decreases reward from non-drug related activity & controls major decision making High risk: - The elderly, adolescents, binge drinkers

  10. Implication on Health & Wellness cont. • Possible individual difference in sensitivity to neurochemical reward • Commonalities between SUDs & overeating associated with obesity • SUDs & obesity aggravated stressors leading to dopamine-modulated neurobiological adaptation • Positive correlation between alcohol & anthropometric markers of adiposity Davis C., Patte K, et al., From Motivation to Behaviour: A Model of Reward Sensitivity, Overeating, & Food Preferences in the Risk Profile for Obesity. Volkow N D, et al., How can Drug Addiction help us Understand Obesity? Nat. Neuroesci. 2005;8(5: 555-560. (PubMed: 15856062). C. Dumesnil et al., Alcohol Consumption Patterns & Body Weight; Annals of Nutrition Metabolism, 2013; 62:91-97.

  11. Strategies for Intervention There are many nutrition-related consequences of SUDs Diet history – reveals changes in eating patterns Often ignored due to shortcuts Lacking the motivation to change or readiness for change Stage of change model

  12. Strategies for Intervention cont. • The goal is to assist recovery/harm reduction • Repair damage to health, mental, physical & emotional • Treatment Programs do not always include nutritional assessment or nutrition education • May not show nutritional deficiencies at admission, often develop nutritional health problems • Good nutrition replenishes nutrient deficiencies

  13. Strategies for Intervention cont. • Assessment information should drive the treatment plan. • Working with high risk populations • Collaboration of services with care providers • Well designed health education • Good nutrition & self-efficacy • Diet & Exercise • Crucial pathway: self-care & commitment to staying sober P. Bardadiri et al., Effect of Edu. Intervention on Nutritional Behavior in Alcohol-Dependent Patients, Alcohol & Alcoholism, Vol. 1, pp 77-79, 2011 David A. Wiss, Self-Efficacy & Nutrition: Promoting Behavior Change in Substance Abuse Recovery, BHN Newsletter, pp 12-13. Winter 2012.

  14. Questions/Answers Thanks for your participation!!

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